Clinical analysis of hydroxyapatite orbital implantation after ocular trauma in 211 cases

Objective： To evaluate the therapeutic effects and complications of hydroxyapatite （HA） orbital implantation on patients after trauma-related surgeries. Methods ： Retrospective analysis was made from 211 cases （211 eyes ） who underwent HA orbital implant placement after trauma-related enucleation or evisceration, including 68 cases of evisceration and primary HA implant placement, 77 cases of enucleation and HA implant placement wrapped with multi-windowed sclera, 66 cases of enucleation and HA implant placement free of wrapping. All the cases were followed up for 1-5 years to observe the therapeutic effects and major complications. Results： Five of 211 cases had wound dehiscence. Ten cases had HA implants exposure, including 1 case suffering severe orbital infection and requiring HA implant removal. The implants exposure incidences by the three surgical methods were from 1.30% to 10.06% and averaged 4.74%. Significant difference was found in late exposure incidence and total incidence from the three methods （ X^2 = 13. 372, P 〈 0.01 and X6^2 = 7. 540, P 〈 0.05 ）. Two cases had shrinkage of the lower fornix. Enophthalmos occurred in 1 case treated by method 1 and was corrected by implanting porous polyethylene （Medpor） plate into the bottom of orbit. In 210 cases, the artificial eye moved well and the cosmetic results were satisfactory. Conclusions- Different surgical methods have their own merit and disadvantage. Enucleation and placement of HA implant wrapped with multi-windowed sclera has corroborated fewer complications than others.